INTRO: The purpose of this study was to investigate the effects of quiet eye training (QET) on inhibitory control, visuospatial working memory (WM), and tonic attention in children with attention-deficit hyperactivity disorder (ADHD). METHODS: Forty-eight children with ADHD aged 9-12 years were randomly assigned to QET and control (CON) groups. The QET group practiced targeted hand-eye tasks within a QET protocol developed to optimize controlled attention and gaze through eye fixations. We used the go/no-go (GNG) test, the Corsi test, and the reaction test of alertness (RTA) to verify the effects of QET on inhibition control, WM, and tonic attention. RESULTS: QET group showed significantly shorter reaction times, a higher number of correct responses, and a lower number of omissions in the GNG inhibition test after QET as compared to the pre-measurements, whereas the CON group did not demonstrate significant changes in this test. The measures of WM (Corsi test) and tonic attention (RTA) did not change significantly with the QET-based intervention. CONCLUSION: The study demonstrated that the QET protocol, which includes instructions and a video demonstration to optimize eye fixation on a target during aiming tasks, is acceptable and usable for children with ADHD. Overall, a short-term, 5-week visuomotor training intervention based on the quiet eye paradigm was shown to be effective in improving inhibitory control and focused visual attention, but not visuospatial WM and intrinsic attention in 9-12-year-old children with inattentive or combined ADHD.

College of Physical Education and Sport PALESTRA Prague Czech Republic

Faculty of Physical Culture Palacky University Olomouc Czech Republic

Zobrazit více v PubMed

Alderson, R. M , Patros, C. H. G. , Tarle, S. J. , Hudec, K. L. , Kasper, L. J. , & Lea, S. E. (2017). Working memory and behavioral inhibition in boys with ADHD: An experimental examination of competing models. Child Neuropsychology, 23(3), 255–272. 10.1080/09297049.2015.1105207 PubMed DOI

American Psychiatric Association (APA) . (2013). Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Association.

Baddeley, A. (2021). Developing the concept of working memory: The role of neuropsychology. Archives of Clinical Neuropsychology, 36(6), 861–873. 10.1093/arclin/acab060 PubMed DOI PMC

Baddeley, A. (2007). Working memory, thought, and action. Oxford University Press.

Barkley, R. A. , Edwards, G. , Laneri, M. , Fletcher, K. , & Metevia, L. (2001). Executive functioning, temporal discounting, and sense of time in adolescents with attention deficit hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD). Journal of Abnormal Child Psychology, 29, 541–556. 10.1023/A:1012233310098 PubMed DOI

Bucci, M. P. , Stordeur, C. , Septier, M. , Acquaviva, E. , Peyre, H. , & Delorme, R. (2017). Oculomotor abnormalities in children with attention‐deficit/hyperactivity disorder are improved by methylphenidate. Journal of Child and Adolescent Psychopharmacology, 27(3), 274–280. 10.1089/cap.2016.0162 PubMed DOI

Carelli, L. , Solca, F. , Tagini, S. , Torre, S. , Verde, F. , Ticozzi, N. , Ferrucci, R. , Pravettoni, G. , Aiello, E. N. , Silani, V. , & Poletti, B. (2022). Gaze‐contingent eye‐tracking training in brain disorders: A systematic review. Brain Sciences, 12(7), 931. 10.3390/brainsci12070931 PubMed DOI PMC

Cowan, N. (2005). Working memory capacity. Psychology Press.

Epstein, J. N. , Langberg, J. M. , Rosen, P. J. , Graham, A. , Narad, M. E. , Antonini, T. N. , Brinkman, W. B. , Froehlich, T. , Simon, J. O. , & Altaye, M. (2012). Evidence for higher reaction time variability for children with ADHD on a range of cognitive tasks including reward and event rate manipulations. Neuropsychology, 25(4), 427–441. 10.1037/a0022155 PubMed DOI PMC

Fried, M. , Tsitsiashvili, E. , Bonneh, Y. S. , Sterkin, A. , Wygnanski‐Jaffe, T. , Epstein, T. , & Polat, U. (2014). ADHD subjects fail to suppress eye blinks and microsaccades while anticipating visual stimuli but recover with medication. Vision Research, 101, 62–72. 10.1016/j.visres.2014.05.004 PubMed DOI

Hitch, G. J. , Hu, Y. , Allen, R. J. , & Baddeley, A. D. (2018). Competition for the focus of attention in visual working memory: Perceptual recency vs executive control. Annals of the New York Academy of Sciences, 1424(1), 64–75. 10.1111/nyas.13631 PubMed DOI

Huang, J.‐H. , & Chan, Y.‐S. (2020). Saccade eye movement in children with attention deficit hyperactivity disorder. Nordic Journal of Psychiatry, 74(1), 16–22. 10.1080/08039488.2019.1666919 PubMed DOI

Kleberg, J. L. , Frick, M. A. , & Brocki, K. C. (2020). Can auditory warning signals normalize eye movements in children with ADHD? European Child & Adolescent Psychiatry, 29(12), 1635–1644. 10.1007/s00787-020-01484-w PubMed DOI PMC

Knudsen, E. I. (2007). Fundamental components of attention. Annual Review of Neuroscience, 30(1), 57–78. 10.1146/annurev.neuro.30.051606.09425 PubMed DOI

Lai, Y.‐J. , & Chang, K.‐M. (2020). Improvement of attention in elementary school students through fixation focus training activity. International Journal of Environmental Research and Public Health, 17(13), 4780. 10.3390/ijerph17134780 PubMed DOI PMC

Li, F. , Zheng, Y. , Smith, S. D. , Shic, F. , Moore, C. C. , Zheng, X. , Qi, Y. , Liu, Z. , & Leckman, J. F. (2016). A preliminary study of movement intensity during a Go/No‐Go task and its association with ADHD outcomes and symptom severity. Child and Adolescent Psychiatry and Mental Health, 10, 47. 10.1186/s13034-016-0135-2 PubMed DOI PMC

Logan, G. D. , & Schachar, R. J. (1997). Impulsivity and inhibitory control. Psychological Science, 8(1), 60–64. 10.1111/j.1467-9280 DOI

Luo, N. , Luo, X. , Zheng, S. , Yao, D. , Zhao, M. , Cui, Y. , Zhu, Y. , Calhoun, V. D. , Sun, L. , & Sui, J. (2022). Aberrant brain dynamics and spectral power in children with ADHD and its subtypes. European Child & Adolescent Psychiatry, 2022, 1–12. 10.1007/s00787-022-02068-6 PubMed DOI PMC

Miles, C. A. L. , Wood, G. , Vine, S. J. , Vickers, J. N. , & Wilson, M. R. (2017). Quiet eye training aids the long‐term learning of throwing and catching in children: Preliminary evidence for a predictive control strategy. European Journal of Sport Science, 17(1), 100–108. 10.1080/17461391.2015.1122093 PubMed DOI

Miles, C. A. L. , Wood, G. , Vine, S. J. , Vickers, J. N. , & Wilson, M. R. (2015). Quiet eye training facilitates visuomotor coordination in children with developmental coordination disorder. Research in Developmental Disabilities, 40, 31–41. 10.1016/j.ridd.2015.01.005 PubMed DOI

Moreno‐García, I. , Delgado‐Pardo, G. , & Roldán‐Blasco, C. (2015). Attention and response control in ADHD. Evaluation through integrated visual and auditory continuous performance test. Spanish Journal of Psychology, 18, E1. 10.1017/sjp.2015.2 PubMed DOI

Moore, L. J. , Vine, S. J. , Cooke, A. , Ring, C. , & Wilson, M. R. (2012). Quiet eye training expedites motor learning and aids performance under heightened anxiety: The roles of response programming and external attention. Psychophysiology, 49(7), 1005–1015. 10.1111/j.1469-8986.2012.01379.x PubMed DOI

Raz, A. , & Buhle, J. (2006). Typologies of attentional networks. Nature Reviews Neuroscience, 7(5), 367–379. 10.1038/nrn1903 PubMed DOI

Rostami, M. , Khosrowabadi, R. , Albrecht, B. , Pouretemad, H. , & Rothenberger, A. (2022). ADHD subtypes: Do they hold beyond core symptoms? A multilevel testing of an additive model. Applied Neuropsychology: Child, 11(3), 280–290. 10.1080/21622965.2020.1806067 PubMed DOI

Schmidt, R. A. , Lee, T. D. , Winstein, C. , Wulf, G. , & Zelaznik, H. (2011). Motor control and learning (5th ed.). Human Kinetics.

Schuhfried, G. (2011a). Corsi: Manual. Vienna test system. Mödling: Schuhfried GmbH.

Schuhfried, G. (2011b). Reaction test: Manual. Vienna test system. Mödling: Schuhfried GmbH.

Siegelbaum, S. A. , & Kandel, E. R. (2013). Prefrontal cortex, hippocampus, and the biology of explicit memory storage. In Kandel E. R., Schwartz J. H., Jessell T. M., Siegelbaum S. A., & Hudspeth, A. J. (Eds.), Principles of neural science (5th ed., pp. 1487–1524). McGraw Hill Inc.

Sanchez, S. , M, F.‐Y. , T, K. , P, D. , Bölte, S. , Lichtenstein, P. , D´Onofrio, B. M. , & Pettersonn, E. (2020). Volitional eye movement control and ADHD traits: A twin study. The Journal of Child Psychology and Psychiatry, 61(12), 1309–1316. 10.1111/jcpp.13210 PubMed DOI PMC

Sjöwall, D. , Roth, L. , Lindqvist, S. , & Thorell, L. B. (2013). Multiple deficits in ADHD: Executive dysfunction, delay aversion, reaction time variability, and emotional deficits. Journal of Child Psychology and Psychiatry, 54(6), 619–627. 10.1111/jcpp.12006 PubMed DOI PMC

Skogan, A. H. , Zeiner, P. , Egeland, J. , Rohrer‐Baumgartner, N. , Urnes, A.‐G. , Reichborn‐Kjennerud, T. , & Aase, H. (2014). Inhibition and working memory in young preschool children with symptoms of ADHD and/or oppositional‐defiant disorder. Child Neuropsychology, 20(5), 607–624. 10.1080/09297049.2013.838213 PubMed DOI

Tarle, S. J. , Alderson, R. M. , Patros, C. H. G. , Arrington, E. F. , & Roberts, D. K. (2019). Working memory and behavioral inhibition in children with attention‐deficit/hyperactivity disorder (ADHD): An examination of varied central executive demands, construct overlap, and task impurity. Child Neuropsychology, 25(5), 664–687. 10.1080/09297049.2018.1519068 PubMed DOI

Türkan, B. N. , Amado, S. , Ercan, E. S. , & Perçinel, I. (2016). Comparison of change detection performance and visual search patterns among children with/without ADHD: Evidence from eye movements. Research in Developmental Disabilities, 49–50, 205–215. 10.1016/j.ridd.2015.12.0020891-4222 PubMed DOI

Tyburski, E. , Kerestey, M. , Kerestey, P. , Radoń, S. , & Mueller, S. T. (2021). Assessment of motor planning and inhibition performance in non‐clinical sample—Reliability and factor structure of the Tower of London and Go/no go computerized tasks. Brain Sciences, 11(11), 1420. 10.3390/brainsci11111420 PubMed DOI PMC

Verbruggen, F. , & Logan, G. D. (2008). Automatic and controlled response inhibition: Associative learning in the go/no‐go and stop‐signal paradigms. Journal of Experimental Psychology, 137(4), 649–672. 10.1037/a0013170 PubMed DOI PMC

Vickers, J. N. (2007). Perception, cognition and decision training: The quiet eye in action. Human Kinetics.

Vickers, J. N. (2009). Advances in coupling perception and action: The quiet eye as a bidirectional link between gaze, attention, and action. Progress in Brain Research, 174, 279–288. 10.1016/S0079-6123(09)01322-3 PubMed DOI

Vine, S. J. , Moore, L. J. , & Wilson, M. R. (2014). Quiet eye training: The acquisition, refinement and resilient performance of targeting skills. European Journal of Sport Science, 14(Suppl 1), S235–S242. 10.1080/17461391.2012.683815 PubMed DOI

Vine, S. J. , & Wilson, M. R. (2011). The influence of quiet eye training and pressure on attention and visuo‐motor control. Acta Psychologica, 136(3), 340–346. 10.1016/j.actpsy.2010.12.008 PubMed DOI

Vuontela, V. , Carlson, S. , Troberg, A. M. , Fontell, T. , Simola, P. , Saarinen, S. , & Aronen, E. T. (2013). Working memory, attention, inhibition, and their relation to adaptive functioning and behavioral/emotional symptoms in school‐aged children. Child Psychiatry & Human Development, 44(1), 105–122. 10.1007/s10578-012-0313-2 PubMed DOI

Weafer, J. , Baggott, M. J. , & De Wit, H. (2013). Test‐retest reliability of behavioral measures of impulsive choice, impulsive action, and inattention. Experimental and Clinical Psychopharmacology, 21(6), 475–481. 10.1037/a0033659 PubMed DOI PMC

Wood, G. , Miles, C. A. L. , Coyles, G. , Alizadehkhaiyat, O. , Vine, S. J. , Vickers, J. N. , & Wilson, M. R. (2017). A randomized controlled trial of a group‐based gaze training intervention for children with developmental coordination disorder. PLoS One, 12(2), e0171782. 10.1371/journal.pone.0171782 PubMed DOI PMC

Wright, L. , Lipszyc, J. , & Dupuis, A. , Thayapararajah, S. W. , & Schachar, R. (2014). Response inhibition and psychopathology: A meta‐analysis of go/no‐go task performance. Journal of Abnormal Psychology, 123(2), 429–439. 10.1037/a0036295 PubMed DOI

Wulf, G. , & Lewthwaite, R. (2016). Optimizing performance through intrinsic motivation and attention for learning: The OPTIMAL theory of motor learning. Psychonomic Bulletin & Review, 23(5), 1382–1414. 10.3758/s13423-015-0999-9 PubMed DOI